Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 3647 | NC |
N | 225XP0200X | Occupational Therapist - Pediatrics | 3647 | NC |
NPI | 1003033895 |
---|---|
Provider Name | Karen Harradine |
First Address | Wilmington, NC 28405-4016 |
Second Address | Wilmington, NC 28401-6663 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2007 |
Last Update Date | 28/10/2021 |